Tooth Damage Research Articles

Understanding the clinical management of co-occurring sleep-related bruxism and obstructive sleep apnea in adults: A narrative and critical review.

Sleep-related bruxism (SRB) is a motor oral behavior characterized by tooth grinding and jaw clenching activity, reported by 8%-12% of the adult general population and 3% of older individuals. The frequency of one of its biomarkers, rhythmic masticatory muscle activity (RMMA), remains elevated across ages. Obstructive sleep apnea (OSA) is associated with the brief and repetitive pause of breathing (apnea) and with transient reduction in oxygen (hypoxia). OSA is observed at all ages and in about 50% of older individuals with a male preponderance. SRB clinical assessment is based on self-reporting of tooth grinding sound, awareness of clenching, jaw pain or headache, and clinical observation of tooth damage. OSA clinical assessment is based on sleepiness and fatigue, snoring, sleep quality, and awareness of breathing cessation, plus clinical examination of anatomical factors (e.g., obesity, retrognathia, large tonsil, macroglossia), age, gender, and body mass. Although the literature does not support association or causality between these two conditions, the co-occurrence is reported in about 30%-50% of adults. To confirm a diagnosis of co-occurring SRB and OSA, home sleep testing (HST) may be indicated. A sleep test is performed using electromyography (EMG) of jaw muscle (masseter or temporalis) and cardio-respiratory variables (e.g., air flow, respiratory effort, oxygen level, heart rate). The management of co-occurring SRB and OSA for individuals with prosthodontic needs is challenging to prevent compromising the oro-pharyngeal space and breathing efficiency. OSA treatment in the presence of SRB includes continuous positive airway pressure (CPAP) use alone or with an occlusal splint or mandibular advancement device (MAD). In addition, the following may be considered: supine sleep correction device, myofuncional therapy, medications, and surgeries. All have limitations and risks. Individual variability suggests that phenotyping is mandatory to select the most efficient and personalized treatment.

A prospective randomized study on the efficacy of real-time dynamic navigation in deep horizontal mandibular third molar extractions

PurposeThis study aimed to evaluate the clinical efficacy of applying real-time dynamic navigation (RDN) in the extraction of deep horizontal mandibular impacted third molars, hypothesizing that RDN reduces surgical time and minimizes the risk of injury to adjacent anatomical structures.MethodsA prospective study was conducted on 160 patients aged between 18 and 37 years with deep horizontal impaction of the mandibular third molar. The participants were randomly assigned to either the experimental group (receiving RDN-assisted extractions) or the control group (undergoing traditional extraction methods). Preoperative planning utilized cone beam computed tomography (CBCT) and Mimics software for the accurate localization and segmentation of impacted teeth. Parametric data were analysed via an independent t test for intergroup comparisons, and significance was set to p < 0.05.ResultsIn the experimental group, an average of 11 ± 1 min was required for preoperative planning via RDN, which was not required in the control group. The setup of the navigation system took an average of 4 ± 1 min in the experimental group and 0 min in the control group. The experimental group demonstrated a significantly shorter average surgical time (22 ± 3 min) than did the control group (36 ± 3 min). The differences in the preoperative design time, surgical time, and complication rates between the two groups were statistically significant (p = 0.005). Additionally, the RDN group reported no complications related to adjacent tooth damage or nerve injury.ConclusionThe precision, safety, real-time guidance of RDN supports its use in complicated dental extractions, which would introduce a new era of oral and maxillofacial surgery.Graphical

Successful Regenerative Endodontic Therapy of a Dens Evaginatus Mandibular Second Premolar with an Acute Apical Abscess and Extensive Periapical Bone Loss: A Case Report.

Regenerative endodontics is a rapidly growing field within dentistry that aims to replace damaged tooth structures and cells of the pulp-dentin complex. This case report presents the successful management of an immature permanent second mandibular premolar with an acute apical abscess and extensive apical bone loss caused by a dens evaginatus. This tooth was unexpectedly treated with long-term calcium hydroxide (Ca(OH)2) that was replenished several times over 6 months. During the treatment process, this tooth became reinflamed developing a chronic apical abscess after resolution of the initial acute apical abscess, which resulted in the replacement and prolonged use of Ca(OH)2. The final regenerative procedures were completed using a bioceramic fast set putty placed directly over the blood clot and an occlusal composite restoration. At the 6-month follow-up, the patient was asymptomatic with a fully healed radiographic lesion, new periodontal ligament, and the apex closed with thickening of the mesial and distal aspects of the root. At the 15-month follow-up, the patient remained asymptomatic with continued evidence of radiographic development of the apical aspect of this tooth, displaying root end closure and thickening. This is a unique case report of the management of a complex infection process in an immature tooth with regenerative techniques with repeated and long-term use of Ca(OH)2. This novel report provides dental practitioners with a new potential protocol for the management of these immature cases with advanced periapical infections that require extensive disinfection to have successful outcomes.

The neural substrates of bruxism: current knowledge and clinical implications.

Bruxism is a complex orofacial behavior that can occur during sleep or wakefulness, characterized by the involuntary grinding or clenching of teeth, involving repetitive activity of the jaw muscles. Its etiology is multifactorial, influenced by genetic, psychological, physiological, and lifestyle factors. While the mild bruxism may not necessitate treatment, severe bruxism can lead to significant consequences, including tooth damage, jaw pain, fatigue, and headaches. The bruxism has been associated with medical conditions, such as stress, anxiety, sleep disorders, and various neurological disorders; however, the exact pathophysiology remains elusive. Although the central nervous system is strongly implicated in the development of bruxism, specific neural substrates have not yet been conclusively established. Furthermore, there is evidence to suggest that individuals with bruxism may exhibit neural plasticity, resulting in the establishment of distinct neural circuitry that control the jaw movements. The application of various neurophysiological techniques in both clinical and pre-clinical studies provides valuable insights into the neural mechanisms underlying bruxism. This review aims to comprehensively examine the current literature on the neural pathways involved in bruxism, with the goal of improving the clinical approach and therapeutics for this condition. A deeper understanding of the neural circuitry controlling bruxism holds the potential to advance future treatment approaches and improve the management of patients with bruxism.

Diagnosis and management of bruxism. A literature review

Bruxism, characterized by involuntary grinding or clenching of teeth, is a widespread condition with multifaceted implications for oral health, physical well-being, and quality of life. This comprehensive review aims to provide an in-depth study of bruxism, encompassing its definition, classification, etiology, pathophysiology, clinical manifestations, and consequences. Bruxism is classified based on its timing (sleep bruxism or awake bruxism). The etiology of bruxism is multifactorial, involving physiological factors such as central nervous system (CNS) pathways, sleep disorders, and occlusal factors, as well as psychological factors like stress, anxiety, personality traits and environmental factors including medications, substances, and stressors. Clinically, bruxism can result in various dental consequences, including tooth wear, fractures and damage to restorations, as well as temporomandibular disorders (TMDs) such as myofascial pain. These manifestations can negatively impact individual's oral health, physical well-being, and overall quality of life. Management strategies include behavioral and lifestyle changes, oral appliances, dental treatments for tooth damage, and, in certain instances, pharmacological interventions. While the current understanding of bruxism has advanced, further research is needed to fully elucidate its etiology, pathophysiology, and effective management strategies.

Progressive Tooth Wear Against Resin-Based Restorative Composites.

The composition and properties of resin-based composite materials could affect tooth wear and lead to clinical problems. Therefore, the study objective was to characterize human tooth wear behavior against a bulk-fill restorative (BF) compared to a conventional resin composite (RC) and a CAD/CAM resin nano ceramic (RN). Square-shaped specimens of each material were prepared and sub-divided according to the number of testing cycles (n=8): 100,000, 250,000, and 500,000 cycles. An occlusal wear test was performed using a chewing machine with 49 N, 2 Hz, in 37°C distilled water. Human premolar cusps were used as antagonists. Micro-CT and laser scanner were used to scan antagonists and specimens, respectively. Wear volume was assessed using a software and the wear pattern was examined with SEM. Softening in solvent analysis was performed by measuring the materials' Knoop microhardness (KHN) before and after immersion in ethanol. Wear volume data were analyzed with two-way ANOVA and Student-Neuman-Keuls test (α=0.05). For tooth and specimen wear volume, there was statistical significance for material and number of cycles, but not for the interaction between factors. BF resulted in less tooth (p=0.008) and specimen (p=0.030) wear than RN and RC, which were similar (p⟩0.05). Volume loss increased from 100,000 to 500,000 cycles. BF showed the lowest microhardness (KHN1); and %ΔKHN similar to RC, but greater than RN. BF induced less volume loss to the tooth than RC and RN, while presenting greater wear resistance. The tooth wear pattern and damage progression were mild for all materials. Resin composites show favorable wear behavior, leading to low volume loss and mild structural damage of the tooth. Regular bulk-fill resin composite stands out for its efficient restorative technique, low wear susceptibility and reduced capacity to wear down the tooth.

Are different screw lengths associated with osteosynthesis quality in the region of the mental foramen?

AbstractIntroductionThe use of two monocortical malleable 04‐hole miniplates, placed above and below the mental foramen, has been indicated to prevent the adverse effects of tension and torsion forces on fracture healing. To obtain good fixation in the mandible's outer cortex screws, 5–8 mm long have been recommended. However, studies have shown thicknesses in the mental foramen region of up to 3 mm, meaning the length of the screw could be a risk to nerve or tooth root damage. The purpose of this study is to identify the influence of screw length on osteosynthesis quality in the region of the mental foramen.Materials and Methods10 synthetic polyurethane human lower jaw replicas were subjected to a linear loading test to evaluate fixation techniques with 5 and 10 mm of displacement. In the photoelastic analysis, 02 lower jaw models were made of photoelastic resin and subjected to linear loading in the fixation technique with 10 mm of displacement. Two 04‐hole miniplates in the region of the mental foramen either fixed completely with 4 mm screws (group 1) or with 5 mm screws in the tension zone and 8 mm screws in the compression zone (group 2). The variables were registered for peak load and peak displacement, and final load and final displacement. One‐way analysis of variance (ANOVA) was applied, followed by the Tukey test, with a significance of 5% (p = 0.05) for the comparisons between the means.ResultsConsidering 95% confidence intervals, the mechanical test showed no statistical differences in peak load between the fixations groups. In the photoelastic analysis, the fringes were concentrated on the distal segment of the fracture in both groups.ConclusionDue to the lack of statistical difference in the biomechanical and photoelastic tests, considering the methodologic limitation, our study indicates a tendency of advantage toward the treatment of fractures with two 04‐hole plates, fixed with 4 mm screws, to minimize complications like tooth or nerve damage. In vivo studies are needed to verify the convergence of the results of in vitro studies to evaluate the resistance and stability in real masticatory forces.

Reduction of sawing forces in bone cutting: Innovative oscillating saw mechanism based on trajectory analysis

Oscillating bone sawing is a critical procedure in orthopedic surgery. However, conventional oscillating saw mechanisms often result in excessive sawing forces, which are detrimental to implant fixation and postoperative patient recovery. Therefore, there is an urgent need to design a new oscillating saw mechanism to reduce sawing forces during surgery, including avoiding ineffective impact forces on bone cutting and preventing ploughing forces caused by negative rake angle contact with the workpiece. In this study, an innovative oscillating sawing mechanism is proposed to effectively inhibit the generation and accumulation of impact forces, avoid negative rake angle contact with the workpiece. Oscillating sawing experiments under various cutting conditions demonstrated that the proposed mechanism significantly reduces cutting forces and prevents defects due to crack propagation of the bone and saw teeth damage. The proposed design offers an effective mechanism to achieve small and stable sawing forces in bone sawing surgery, and it inspires tailored oscillating saw techniques for specific machining needs, such as thin deep groove cutting.

Empowering Communities Through Capacity Building Dental And Oral Health Screening And Counseling In Kedungwinong

The main issue for the elderly is the loss and damage of many teeth, leading to difficulties in chewing food. The most common cause of tooth loss is poor oral health, particularly dental caries and periodontitis. Elderly individuals often neglect oral hygiene and frequently complain of dental issues such as loose teeth, cavities, or swollen gums. The purpose of empowering communities through capacity building was to increase awareness of the importance of maintaining overall health, dental and oral health, and to assess the level of knowledge and the status of dental and oral health among the residents of Kedung Winong. The proposed solution to the problem is to increase residents' awareness of maintaining dental and oral health, enhance their knowledge of proper tooth brushing techniques, promote the habit of brushing teeth at appropriate times, and raise awareness about the importance of regular health check-ups as a preventive measure against chronic diseases. Methods of oral health counseling and examinations was chosen to solve the problems. The counseling and examination activities for the community in the Muhammadiyah and Aisyiyah branches in Kedungwinong, Nguter, Sukoharjo, were successfully implemented, with enthusiastic and cooperative participation. The activities effectively raised awareness about the importance of dental and oral health.

Esthetically driven immediate provisionalization in the anterior zone: 5-year results from a prospective study evaluating 3.0-mm-diameter tapered implants

ObjectivesEvaluate the 5-year safety and efficacy of a narrow-diameter (3.0 mm) implant that was immediately provisionalized with a single crown in the maxillary lateral incisor or mandibular central or lateral incisor area.Materials and methodsAn open, prospective, single-cohort, multicenter study was conducted, in which narrow-diameter implants were placed in fresh, healed extraction, or congenitally missing sites. All patients were required to meet strict criteria for immediate loading. The primary endpoints were marginal bone levels (MBL) and MBL changes (MBLC) from implant placement to 5-year follow-up. Secondary endpoints included cumulative 5-year survival and success rates, soft tissue health, and esthetic parameters.ResultsA total of 91 implants were placed in 77 patients. The mean MBL remained stable from the 1-year (− 0.79 ± 0.73 mm, n = 75) to 5-year (− 0.74 ± 0.87 mm, n = 65) follow-up. A marginal bone gain of 0.11 ± 0.83 mm was observed from the 1-year to 5-year follow-up. The cumulative 5-year survival rate was 96.5%, and the cumulative 5-year success rate was 93%. The clinical parameters, including the modified plaque index, modified sulcus bleeding index, Jemt’s papilla index, and pink esthetic score improved throughout the 5-year study.ConclusionsThe study demonstrated that narrow-diameter implants represent a safe and predictable treatment option for subjects suitable for immediate loading and with limited bone volume or limited inter-dental space.Clinical relevanceNarrow-diameter implants with immediate provisionalization can be considered for use to restore missing or damaged teeth with predictable functional and esthetic outcomes. This trial was registered with ClinicalTrials.gov (NCT02184845).

Comparison of two different positions of an anaesthesiologist for ease of endotracheal intubation in adult patients: A randomised control trial

Background and aimsMaintaining the airway with a cuffed endotracheal tube (ETT) in the trachea remains one of the most essential anaesthesia skills. Many parameters were described to assess the difficulty of intubation in the preoperative period, but none allow the prediction of all difficult intubations. The correct posture of the anaesthesiologist is also an important factor for successful endotracheal intubation. The aim of this study was. This study aimed to compare the impact of two different positions of an anaesthesiologist (sitting vs. standing) at the time of endotracheal intubation. MethodsOne hundred ten American Society of Anaesthesiologists (ASA) Physical Status I/II patients, aged between 17 to 65 years, Mallampati grade I/II, mouth opening 39–70 mm, thyromental distance (TMD) 6–6.5 cm, and sternomental distance (SMD) >13 cm, scheduled for elective laparoscopic cholecystectomy, were recruited. Patients were divided into two groups; Group I consisted of patients who underwent endotracheal intubation by an anaesthesiologist in a sitting posture, while Group II encompassed patients who underwent endotracheal intubation by anaesthesiologists in a standing posture. Assessment parameters include ease of intubation (IDS score), intubation time, intubation success rate, number of attempts, grade of laryngoscopy (Cormack Lehane score, POGO score), and complications like tooth and soft tissue damage. ResultsThe ease of intubation was higher in group I, 1(0–1), than in group II, 1(1−2) (p = 0.02), and there was a significant difference between the two groups. The Cormack Lehane grade (CL) was I/IIa/IIb/III in 19/23/13/0 in group I and I/IIa/IIb/III in 13/21/18/3 in group II. The first-attempt intubation success rate for groups I and II was 94.54 % and 92.72 % respectively. ConclusionThe sitting posture of an anaesthesiologist at the time of laryngoscopy provides a better intubating condition when compared with the standing posture. RegistrationClinical Trial Registry - India (CTRI) CTRI/2023/03/050371.

Orthodontic and Surgical Management of Impacted Maxillary Canines: A Narrative Review

AbstractMaxillary canine impactions are a significant challenge for orthodontic and oral surgical practices. In this narrative review, we aim to evaluate surgical and orthodontic approaches for treating maxillary canine impactions, evaluate their effectiveness, and compare the two treatment modalities.We reviewed several studies on databases such as Google Scholar, PUBMED, and MEDLINE to update recent knowledge for canine impactions and their treatment. We reviewed and included studies that matched our research objectives, including orthodontic management, open and closed eruption techniques, and contact and tooth alignment surgery.Successful treatment results of canine impactions were reported increasingly in literature, and good clinical outcomes were observed in most cases. However, factors such as the severity of the impaction, patient age, and surgical experience were found to influence the choice of surgical technique and success rates. Complications associated with surgical management of maxillary canine impactions were also reported. These complications, which include tooth resorption, postoperative infection, ankylosis, and damage to adjacent structures, are generally rare but emphasize the importance of careful patient selection, surgical planning accuracy, and emphasis on diligent postoperative care.Findings highlight surgical procedures' effectiveness, outcomes, and challenges to help clinicians make informed decisions and improve patient care. The results underscore the importance of evidence-based decision-making and a multidisciplinary approach for successful clinical outcomes. Future research will focus on long-term stability, patient-reported outcomes, and exploring emerging techniques to further improve the management of maxillary canine impactions.

Prevention of Oral Injuries during Endotracheal Intubation: Patients' and Anesthesiologists' Perspective.

The aim was to design accessible, simple, inexpensive protection for teeth and soft tissues during ETI, compare damage occurrence with and without protection, and investigate post-ETI orofacial pain symptoms. The selection procedure for adequate protection was carried out after which a reduced elastomer mouthguard was selected. Fifty patients were divided into 2 groups. In the first group, ETI was carried out using a mouthguard, while in the second group it was performed without it. The mouthguard was fabricated by anesthesiologists. After the ETI procedure, the patients and anesthesiologists were asked to complete a survey. No difference in intubation severity and time required for intubation between the two groups was present. Seven patients from the non-mouthguard group suffered injuries during the ETI procedure. No injuries were present in the mouthguard group. In 92% of cases anesthesiologists agreed that mouthguards should be used during ETI. However, most of them (96% of cases) agree that the mouthguard should be used only when there is an increased risk of tooth loss and/or tooth damage. There was a significant ETI effect on the emergence of new orofacial pain cases. The mouthguard adequately protected dental and soft tissues and did not affect the work of the anesthesiologist. A significantly higher number of patients experiencing temporomandibular joint and masticatory muscles pain after surgery indicates that ETI might be a risk factor for orofacial pain.

Comparative evaluation of the differential staining ability of carbol fuchsin, methylene blue, and turmeric GC-MI paste between enamel and adhesive composite remnant after orthodontic debonding using a spectrophotometer

Background: After debonding, the primary concern of the clinician is to ensure the complete removal of the orthodontic adhesive composite remnant and restore the tooth surface to as near its original state as possible. However, the color resemblance of composite adhesive and enamel can increase the risk of tooth damage during debonding. To delineate composite from enamel, using various hydrophobic stains can be helpful in clean debonding. Objective: The aim of the present research was to assess and compare the differential staining ability of three stains, i.e., carbol fuchsin, methylene blue, and turmeric GC-MI paste, using a spectrophotometer. Methodology: A total of 48 premolar samples were distributed among three groups, namely, Group A, Group B, and Group C. Each group of 16 samples was stained with carbol fuchsin, methylene blue, and turmeric GC-MI paste, respectively. The color value of enamel and composite was measured before and after staining by digital spectrophotometer using CIE L* a* b* scoring method. Results: The mean difference color value of composite and enamel before and after staining was found to be 38.473 ∆ E, 17.211 ∆ E, and 18.715 ∆ E and 1.647 ∆ E, 1.297 ∆ E, and 1.293 ∆ E in Groups A, B, and C, respectively. The mean color value of composite and enamel was compared before and after staining using a t-test for all three groups and was found to be statistically highly significant. Conclusion: Carbol fuchsin, methylene blue, and turmeric GC-MI paste have the potential to be used as composite disclosing agents. Turmeric GC-MI paste appears to be a better agent as it stains composite effectively without significant staining on enamel.

Management of mandibular angle and body fractures using miniplates and 3D plates.

Mandibular angle fractures have the greatest recorded rate of postoperative complications of any mandibular location and hence they present an especially difficult task for surgeons. Therefore, it is of interest to compare the conventional miniplates and three dimensional (3D) plates in management of mandibular angle fracture and body fractures.60 patients with isolated non-comminuted mandibular angle fractures and body fractures were randomly assigned into two groups by lottery. Utilizing Champy's osteosynthesis standards, group one (n = 30) received treatment with 2-mm standard miniplate and group two (n = 30) had treatment with open reduction and internal fixation utilizing 2-mm 3D locking stainless steel plates. The mean operative time was greater in conventional miniplate category as compared to three dimensional plates. Need for postoperative occlusion correction was lesser n 3 dimensional plate category. The incidence of postoperative infection was comparable in both categories. Incidental tooth damage was lesser in three-dimensional plate's category three-dimensional locking plates are an alternate strategy that has a comparable result profile to miniplates.

EVALUATING ACETONE AND METHANOL FOR ELECTROPHORETIC DEPOSITION OF SS 316L COATED WITH HYDROXYAPATITE/MULTIWALLED CARBON NANOTUBES DENTAL IMPLANTS: A FOCUS ON CORROSION RESISTANCE

Dental implants offer a reliable solution for replacing damaged tooth roots. This research investigates the comparative performance of acetone and methanol as suspension media in the fabrication of stainless steel type 316L-based dental implants using the Electrophoretic Deposition (EPD) method, a technique known for its simplicity and cost-effectiveness. Voltage variations of 20V, 30V, and 40V were applied to both acetone and methanol suspensions for a duration of 20 minutes. The morphology of the Hydroxyapatite/Multiwalled Carbon Nanotube (HA/MWCNT) coatings was meticulously characterized using Scanning Electron Microscopy (SEM). Corrosion resistance was evaluated through Potentiodynamic Polarization (PDP) and Electrochemical Impedance Spectroscopy (EIS) techniques. Remarkably, at 30V, a homogeneous and crack-free coating was achieved, demonstrating superior corrosion resistance. This was further corroborated by the resistance values of 23.891 Ω and 114.990 Ω for the acetone and methanol samples, respectively. Additionally, the corrosion rates of 0.075 (mmpy) and 0.0004 (mmpy) for the acetone and methanol samples further emphasized the superiority of methanol as a suspension medium. These findings unequivocally establish methanol as the optimal choice for achieving superior deposition quality and corrosion resistance in the context of the EPD method for stainless steel type 316L-based dental implants.

Patient-centered Care in Dentistry

Patient-centered care (PCC) in dentistry is a holistic approach that considers not just the dental condition but also the patient’s individual preferences, needs, and values (Kristensen et al., 2023). It aims to ensure that patient values guide all clinical decisions, fostering a collaborative and respectful patient-dentist relationship. It tries to make sure patients’ values determine clinical decisions so that an interaction involving both the dentist and a patient-centered approach with respect will result. This interconnection in dentistry goes further because psychosocial factors, such as experiencing dental phobia and one’s economic class, affect oral health significantly. Dental phobia, which can create treatment avoidance, accentuates the necessity of comprehending and addressing such issues to provide effective and patient-centered care (Kristensen et al., 2023). Another issue is economics, which can hinder getting care, especially when dealing with a low-income group. Data shows that PCC is associated with a reduction in the use of health resources, better patient satisfaction, and better overall health. Additionally, PCC can aid professional healthcare workers when it comes to litigation cases, and it reduces work dissatisfaction, which is another indicator of its value. Integrating objective data into treatment strategies is essential for effectively implementing PCC in dentistry. Objective data, for instance, clinical parameters that can be quantified, serve as a research basis that completes the information patients can provide regarding their subjective experiences (DrKumo, 2023). Integration of the two of them provides a broader picture of the patient’s current oral health status and the potential available treatments. For example, tracking a patient’s hard data figures of probable oral wellness indicators like gingivitis and tooth damage alongside their subjective details, such as reported symptoms or concerns, can aid in recognizing patterns and customizing treatment plans to achieve better results by offering optimized services to the patients (DrKumo, 2023). However, despite the bright side of PCC, there are also some difficulties that persist; among them, one can highlight the absence of a uniform definition and detailed recommendations for its application in dentistry. Reasonable attempts are being made to tackle them by virtue of a theory-based PCC model created with the dental setting as its core area of application. However, additional research that would entail empirical testing of the model and its practicality is needed to realize the potential for developing patient-centered care in dentistry, indicating the rising importance of this model and its timely implementation in dentistry.

Research progress of dental pulp regeneration treatment.

The dental pulp is the only soft tissue structure within the tooth, serving functions such as sensation and nutrition. However, the dental pulp is highly susceptible to necrosis due to external factors. Currently, root canal therapy is the most commonly used treatment for pulp necrosis. Nevertheless, teeth treated with root canal therapy are prone to secondary infections and adverse outcomes like vertical root fractures. Regenerative endodontic therapy has emerged as a solution, aiming to replace damaged tooth structures, including dentin, root structure, and the pulp-dentin complex cells. This approach demonstrates significant advantages in addressing clinical symptoms and achieving regeneration of the root and even the pulp. Since the discovery of dental pulp stem cells, regenerative endodontic therapy has gained new momentum. Advances in cell transplantation and cell homing techniques have rapidly developed, showing promising potential for clinical applications.

Enhancing subgingival margin restoration: a comprehensive review and meta-analysis of deep margin elevation's impact on microleakage.

Restorative dentistry faces complex challenges with deep proximal surface destruction, requiring novel approaches like DME (Deep Margin Elevation). In order to achieve the best results while treating severe tooth damage, this study examines the advantages, disadvantages, and possible collaborations of different treatments. This systematic review investigates the efficacy of DME as an adjunctive procedure in restorative dentistry, specifically focusing on its impact on microleakage. The study adheres to PRISMA guidelines and employs the PICOS framework for eligibility criteria. 394 potentially qualifying studies were discovered andthorough literature search was carried out via databases. After applying inclusion criteria, 7 studies were included in the analysis. Articles were selected based on criteria that included indirect restoration and performing DME and were compared with indirect restorations without DME. Composite resin was used for DME. Other materials for DME performing, including GI and composite flow, were systematically reviewed. Data analysis was done by biostat software (α = 0.05). The meta-analysis of selected studies reveals a statistically significant positive effect of DME on reduction of microleakage (p = 0.001). The results of this study underscore the potential of DME in addressing subgingival margin challenges and provide valuable insights for restorative dentistry practices.

WITHDRAWN: Unveiling the future of endodontics: An update on dental pulp regeneration strategies

Pulpal and periapical ailments, prevalent oral afflictions, result from irreversible perturbations to dental pulp caused by potent stimuli such as caries, trauma, or iatrogenic factors. Current treatments include root canal therapy and pulp revascularization, yet achieving complete pulp tissue regeneration remains challenging. Recent advancements in biomaterial science and tissue engineering have shifted focus towards employing diverse methodologies for restoring damaged tooth pulp. These include stem/progenitor cell populations, revascularization techniques, scaffolds, and material-based approaches. Notably, the identification of dental pulp stem cells (DPSCs) has increased interest in stem cell-mediated pulp regeneration. Current research explores cell transplantation and homing strategies. Despite progress, challenges persist in preclinical and clinical applications. This narrative review assesses the current state of regenerative endodontics, emphasizing dental pulp regeneration techniques, including their advantages, drawbacks, and biological aspects such as DPSCs, biomaterials, and growth factors. Challenges and potential solutions are discussed to guide future clinical translation, offering insights for advancing regenerative endodontics.